In hospital, having gallbladder out, anesthesia questions?

[Tracy9]

I was emergently and unexpectedly admitted to the hospital yesterday morning with an infected gallbladder full of stones. I am on IV antibiotics and waiting for my Coumadin level to come down so they can do surgery tomorrow.


The anesthesiologist just came in. He said that because of the myasthenia, intubating me for the surgery will be "tricky" and that he will leave it up to the doctor actually doing the surgery to decide exactly how to do it. Any idea what that is about? Secondly, he said because of the myasthenia, I could wake up on a vent and I should be prepared for that. How likely is that to happen for a simple surgery like this? I haven't had surgery since being diagnosed with myasthenia.

Thanks for your help. It's about a one hour surgery and I'll be getting propofol.

[pingpongman]

Wow I'm very interested in answers as I have Gall stones also. Come on guys and gals!
Mike

Originally Posted by Tracy9

I was emergently and unexpectedly admitted to the hospital yesterday morning with an infected gallbladder full of stones. I am on IV antibiotics and waiting for my Coumadin level to come down so they can do surgery tomorrow.


The anesthesiologist just came in. He said that because of the myasthenia, intubating me for the surgery will be "tricky" and that he will leave it up to the doctor actually doing the surgery to decide exactly how to do it. Any idea what that is about? Secondly, he said because of the myasthenia, I could wake up on a vent and I should be prepared for that. How likely is that to happen for a simple surgery like this? I haven't had surgery since being diagnosed with myasthenia.

Thanks for your help. It's about a one hour surgery and I'll be getting propofol.

[suev]

Your anesthesiologist was preparing you for what could happen - not, necessarily, what will happen. Remember, lots of folks here have had their thymus removed (6-8 hours of surgery for some) and I don't remember anyone saying they stayed on the vent after recovery room.

I'll bet all goes well and that you feel much better after that gallbladder is dealt with! Let us know how you make out when you're up to it.

[Tracy9]

Good point. That's reassuring.

[tysondouglass]

Originally Posted by Tracy9

Good point. That's reassuring.

I agree, Unless your mg is very unstable- I doubt the % you wake up w a vent is very high. Yet if you do, some of us can help you through that too.

1 day at a time, is what you need to focus on at the moment. Breathe and be well. Good luck!

[Annie59]

Tracy, I have had minor surgery since MG hit hard in 08 with hosp #1. I called the anethsiologist well before th eye surgery and discussed my breathing and told her that I would be glad to provide records on recent pulmonary function tests so she knew to what degree I was compromised on a day to day basis. I said she could talk to my pulmonogist as well. This is the value of having a pulmonogist as most neuros dont even undestand the pulm tests. As passionate as my pulm doc at the university and Mayo is about how poor my breathing is, with being seronegative if I had let the univserity neuro speak for me she would have generalized and possibly not done anything as usual putting me at risk. I am a huge beliver in having a pulmonogist.

The anesthesiologist was very understnding and knowlegeable and confident taking that I had MG seriously and went lite on the anesthesia. What the anesthesiaologist said to you concerns me in that they were gonna let the doc decided what to do. The anesthes should know what to do not defer. If he dosent have experince do you want him/her? I dont know if it is possible but I would like you to have someone that gets it/has experience with the MG need. That just sounds scary to me as your doc is not the anesthesiologst.

Annie59

[Tracy9]

Oh Annie, just to clarify, he meant the anesthesiologist that will actually be on my case today. He was consulting with me, but was not going to be my doctor. That's what I meant, THAT doctor. Not the surgeon, but the anesthesiologist.

Thanks for all the info!

[Marin826]

It's about a one hour surgery and I'll be getting propofol.[/quote]

Tracy!
How old are you ( I ask, because younger people tend not to have many stones)?
How often this gallbladder gives you pain problems?
Did you ask your GI Dr,what are your options,if you don't get it removed?
It became a common practice now to get gallblader removed with first acute pain manifestation.
But I remember,my grandmother lived with that for many years without surgery.

I am very caushious about this,because my daughter did have problem with her thymectomy and prolong intubation ( well,nobody cared to get her MG under control before surgery- now I understand that).
Of course,this one is not that serious and long surgery ( now they do a few insisions and do it laparoscopically).Propofol- is not a general anestesia,it's more like sedation.So,it's a big difference.
But it's just my thought -please,consider all pro and contras.
Good luck with whatever you decide.Hope,everything will go great.

[Annie59]

Hi Tracy I sure hope you are doing well. I am sorry if my current fear level from my gastro and other issues came out in my message to you. I did find a general article on propofol use in endoscopic proceedures. While it is pretty techy and you may well be done it seems positive and it reasurred me as I may well be headed for a similar proceedure with my gastro stuff. I did the WebMD symptoms program and came up with pancreatitis and Tylenol poisoning at the top of the list at the end. I remembered also a mini lecture from my internist about the internal organs that can be affected by my Sjogrens. The pancreas is one of them.

http://www.medicalnewstoday.com/articles/216658.php

I am sending you a little gentle hug.

Annie59

[Southern Bell]

Hi everyone. I've been reading this site for about 9 months or so and have been amazed at the ordeal many of you have had to endure just to be diagnosed. My journey started on 5/1/09 with symptoms slowly escalating to the point that I was in the emergency room by 5/12. Went to Emory Healthcare in Atlanta thinking that it would be the best place to be since I have never been sick and never been in the hospital in my life (not so sure about that decision because of mistakes that were made in the 2 1/2 months that I was either in the hospital or in rehab). Anyway after spending most of the day in the emergency room with several neurologist pondering my symptoms, a simple xray showed the problem - a large thymoma. After CT scans and MRI's the decision was that it had to be removed as it was attached to my heart sack and my lung. Survived that surgery and thankfully the tumor was not malignant. Was diagnosed with not only myasthenia but also stiff person syndrone. I hit the autoimmune jackpot.

When the first symptoms of stiff person starting to show they immediately put me on Mestinon - I am very alergic to Mestinon so that put me in ICU for a week on a respirator and close to heart failure. Once again I survived that.

After loosing 35 lbs the neuro wanted to have a feeding tube inserted and after much debate with my husband, we agreed. After about two weeks it was discovered that the feeding tube had pierced my colon and I had emergency colon repair surgery. After which I was left with a temporary colostomy. I was told by my surgeon that I would have to leave the ostomy in for two months to ensure that my colon would heal because they are hesitant to put me under general anesthenia because the myasthenia effects your lungs and recovering from anesthenia is very difficult. What they did was give me a spinal block to numb my lower body, but because of the stiff person symptoms they must have given me something more to knock me out because I remember going into the operating room but the next thing I knew I was being taken to recovery.

I apologize for writing such a long first post. I feel like I could write a War and Peace novel (mostly war). That's the southern part of me.

I do hope your doctors take everything about your condition into account and that the outcome is successful. Best of luck.

Southern Bell